Adoption Application Form

Name of the Dog applying for:

Full Name

First NameLast Name

Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Email Address*

Current Occupation

Employer's Name

Partner/Spouse's Name

List household members, (age required)*

PLEASE LIST ALL HOUSEHOLD MEMBERS AGES

Have you ever owned a pet before

Do you provide your dogs with regular dental cleanings

Tell us a little about the animals you currently have in your home

Anyone in your household allergic to dogs

Have you ever owned a dog that require regular grooming

The average cost of grooming is over $600 or more per year for a "fluffy" dog.

Are you willing to pay for transport your pet to you? (if needed)

Do you Own or rent your home

RentOwnLive with Parents

Can you provide proof that your landlord or HOA allows pets?

YesNo

How long have you lived at your current address?

Where will you keep your pet during the daytime?

Where will your pet sleep at night?

How will you care for your pet during overnight family absences and vacations?

What type/brand of dog food do you plan to feed your dog?

Do you have a fenced yard?

How will you ensure your pet's safety?

Where will your dog spend his/her time when alone?

Do you have a doggie door? *

* Please note that we do not approve homes with doggie doors that lead to an open spaces where our dogs can be exposed to wildlife dangers

Do you plan to use a crate?

DefinetilyMaybeProbably not

What will you do if your dog is destructive when left alone?

Are you willing to attend obedience training with your dog?

DefinitelyMaybeProbably not

Have you ever surrendered, sold, or given away your pet to an animal shelter or rescue group? If Yes, why?

Has anyone in your immediate family or household ever been convicted of a charge related to cruelty to animals or child abuse? Are there any pending charges now?

Who is or will be your regular veterinarian? (Include address and phone number)

Please provide Three References...including phone number and email (required)

Are you willing to email us a photo of your home, yard, and fence prior to adoption?

Do you have any more information you would like Scratch My Belly to consider in reviewing your application?

I understand that SMB may receive several applications for the dog I'm applying for, and in that event, the best home will be selected based on the dog's needs.

I Agree

I understand that an tax-deductible Adoption Donation will be collected at the time of the Adoption. I understand this Adoption Donation is NON-REFUNDABLE.

I Agree

By signing below, I agree that I have answered the questions to the best of my knowledge and have not knowingly submitted false or misleading replies. I understand that Scratch My Belly reserves the right to refuse adoption to any applicant. I accept these terms.

I Agree

Enter the message as it's shown*

Full Name

First NameLast Name

Date

MonthDayYear

ADOPTION APLICATION